Meredith, who died in a state institution in Clarinda, Iowa, in September, was one of the last survivors of what is now considered a barbaric medical practice. He was one of tens of thousands of Americans who underwent lobotomies in the 1940s and '50s.

Meredith's older sister, Cleojean Olson of Des Moines, said he started showing signs of anxiety and repetitive behaviors as a teenager. Her descriptions, bolstered by medical records, portray a young man who today might be diagnosed with a moderate form of autism.

Meredith spent time at several institutions, and his treatment included numerous rounds of electroshock therapy, Olson said.

When he was 24, their parents received a letter from a state administrator saying that a doctor had performed a lobotomy on him. The procedure left her brother even more passive than before.

"It was just like they took the life out of him," Olson said. "He was like a zombie."

After the operation, her brother had two black eyes, a telltale side-effect of the most popular lobotomy method.

A doctor would insert a sharp instrument, similar to an ice pick, into the top of the patient's eye socket. The doctor would tap the back of the instrument with a hammer, pushing the pick into the brain. He would rotate the pick in an arc, cutting nerve connections between the front and center parts of the brain. Then he would do the same thing at the other eye socket.

The procedure's main proponent, neurologist Walter Freeman of Washington, D.C., bragged that it was so simple to perform that it didn't require a surgeon or an anesthesiologist.

Journalist Jack El-Hai, who wrote a biography of Freeman, estimates that 40,000 to 50,000 Americans had lobotomies. Most of the patients were residents of state mental institutions or Veterans Administration hospitals, he said in an interview. The procedure usually was not meant to cure a patient's mental illness, he said.

"But it could blunt symptoms, and if enough symptoms were made to disappear, then maybe the patient could go home," he said.

At first, he said, the procedure was used on people with serious psychoses and severely disruptive symptoms. But as time went on, the procedure was used in other types of cases, including many involving depression or obsessive behaviors.

The procedure fell out of favor in the late 1950s. Freeman eventually lost his medical license.